In a highly touted safety achievement, deaths on the nation's roads
and highways have fallen sharply in recent years, to the lowest total in more than a half-century. But motorcyclists have missed out on that
dramatic improvement, and the news for them has been increasingly grim.

So it might be no surprise that biker groups are upset with
Washington. The twist is what they are asking lawmakers and regulators
to do: Back away from promoting or enforcing requirements for safe
helmets, the most effective way known to save bikers' lives.

Fatalities from motorcycle crashes have more than doubled since the mid-1990s. The latest figures show these accidents taking about 4,500 lives a year, or one in seven U.S. traffic deaths.

Yet if the biker groups' lobbyists and congressional allies have
their way, the nation's chief traffic cop — the National Highway Traffic
Safety Administration, or NHTSA — will be thwarted in its efforts to
reduce the body count. The agency would be blocked from providing any
more grants to states to conduct highway stops of motorcyclists to check
for safety violations such as wearing helmets that don't meet federal
standards.

Beyond that, the rider groups are seeking to preserve what
essentially is a gag rule that since 1998 has prevented NHTSA from
advocating safety measures at the state and local levels, including
promoting life-saving helmet laws. And the bikers' lobbyists, backed by
grassroots activists and an organization whose members include a "Who's
Who" of motorcycle manufacturers, already have derailed a measure lawmakers envisioned to reinstate financial penalties for states lacking helmet laws.

Those moves partly are intended to maintain the bikers' clout in
state legislatures, which have kept rolling back motorcycle helmet
regulations for three decades. With Michigan's repeal in April of its
nearly 50-year-old helmet requirement covering all riders, only 19
states have such helmet laws, according to the Insurance Institute for Highway Safety. In the late 1970s, by contrast, 47 states had requirements covering all riders.

"This is…an interesting and dangerous road they are going down," said
Jackie Gillan, president of the Washington-based nonprofit Advocates
for Highway and Auto Safety. "They are so emboldened now, not only do
they try to repeal laws and stop them from being enacted, they try to
stop the hands of law enforcement, saying you cannot use grant money to
have motorcycle checkpoints. Can you imagine if they said the same thing
about sobriety checkpoints?"

Biker groups, contending that helmet laws curtail personal freedom,
say the federal government instead should emphasize rider training to
prevent crashes from happening in the first place. They urge NHTSA,
which has spent upwards of $30 million on training through an
industry-endorsed grant program that Congress established in 2005, to
step up that effort.

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But it is far from clear that training does anything to reduce crashes or deaths. A 2007 Indiana study, for instance, found that riders who completed a basic training course were 44 percent more likely
to be involved in an accident than untrained riders. Researchers
speculated that the courses gave riders unwarranted confidence, and that
they ended up taking more risks.

Mandatory helmet laws are widely considered the closest thing to a
silver bullet that regulators have to thwart deadly accidents. NHTSA estimates
that helmets saved 1,483 lives in 2009, and that another 732 deaths
could have been avoided if all riders had worn them. The social costs of
the carnage are also huge: a 2008 agency estimate concluded that $1.3
billion in medical bills and lost productivity would have been saved if
all bikers had worn helmets.

The paradox between what biker groups are lobbying for versus what
most safety experts say really works riles regulators and other public
health advocates.

"You cannot be in this battle and not be frustrated by this
senselessness," said Michael Dabbs, president of the Brain Injury
Association of Michigan.

He added that the personal freedom that riders seek would have
socially unacceptable consequences if carried to its logical extreme.
"Maybe we ought to save some of the costs when police or emergency
responders go to the scene of a crash and the person is not wearing a
helmet," Dabbs said. "Perhaps they ought to be left there like
roadkill."

The National Transportation Safety Board, an independent
investigative and advisory agency, includes motorcycle helmets among its
"most wanted" transportation safety improvements and has urged states
to make them mandatory. Likewise, NHTSA Administrator David Strickland has said
of helmets: "No other single countermeasure offers a comparable body of
supporting scientific evidence confirming its potential for saving
lives of motorcyclists."

Libertarian message

That motorcyclists have evaded the kind of regulation that has made
seat belts and car seats standard equipment in other motor vehicles
shows the influence of a vocal minority of riders whose libertarian
message seems to resonate more than ever with lawmakers inside and
outside the Beltway. And their efforts receive support from the leading
motorcycle manufacturers. Manufacturers generally endorse the use of
helmets but, loath to offend their customers, they also are an important
dues-paying membership bloc in the American Motorcyclist Association,
an ardent opponent of helmet laws.

For example, Harley-Davidson Inc. said through a spokeswoman that it
"supports and encourages safety for all motorcycle riders, but believes
in the personal freedom of people making the choices that are right for
them regarding helmet use."

The rider lobby's powerful friends include U.S. Rep. James
Sensenbrenner, R-Wis., whose state is home to Milwaukee-based
Harley-Davidson. He has led efforts in the House to block NHTSA from
promoting state and local safety measures and using federal funds for
motorcycle checkpoints.

The repeal of Michigan's long-standing helmet law had been opposed by
a coalition of more than two dozen medical and public health groups led
by the Brain Injury Association of Michigan. Public opinion, too,
weighed against the move — a poll indicated that 80 percent wanted to
keep the helmet law. State safety officials predicted the repeal would
lead to at least 30 more deaths a year.

Motorcycle activists, led by the local chapter of a group calling
itself American Bikers Aiming Toward Education, or ABATE, framed the
issue as a matter of personal liberty. They also argued that the repeal
would draw more riders to the state and increase tourism.

In Michigan, riders 20 and younger still must wear helmets, and the
new law requires motorcyclists to have at least $20,000 in medical
insurance. But those who advocated keeping the helmet requirement for
all riders said the $20,000 in insurance would not come close to
covering the cost of a catastrophic injury.

Compelling evidence

Nationally, the evidence that helmets prevent head injuries and deaths has long been compelling. Two decades ago, a Government Accountability Office analysis identified 46 academic studies that showed helmets saving lives and reducing the social burden of caring for injured riders.

Even the American Motorcyclist Association readily acknowledges that
helmets that meet Transportation Department standards can prevent
serious injury or even death in the event of a crash, and encourages
their use, although the group still says riders should have the option of not wearing one.

Recent studies also have rebutted a long-standing assertion by rider
groups that helmets can increase the chances of cervical spine injuries
because of the greater torque they place on the neck. Johns Hopkins
University researchers, in a study
published last year that reviewed 40,000 motorcycle collisions, found
the opposite to be true: the helmeted riders were 22 percent less likely
to suffer cervical spine injury than those without helmets.

"We are debunking a popular myth," said Adil H. Haider, the leader of
the study and an assistant professor of surgery at Johns Hopkins.

Motorcycle groups have also become better organized and funded,
roaring to life with Washington lobbyists and thousands of grassroots
volunteers to fight helmet requirements on the federal and state levels.

The American Motorcyclist Association
– whose corporate members include Harley-Davidson and North American
divisions of Yamaha, Kawasaki, Honda and Suzuki – has spent $3.8 million
lobbying Congress on helmet laws and other issues over the last decade,
while doling out more than $200,000 in campaign contributions to members, according to OpenSecrets.org, a database run by the nonprofit Center for Responsive Politics. The Motorcycle Riders Foundation spent $2.1 million in lobbying during the same period.

That is the force that Sen. Frank Lautenberg, D-N.J., a long-time
supporter of mandatory helmet laws, ran into last December. He was
poised to introduce a proposal to the Senate Commerce, Science, and
Transportation Committee that would have forced states to pass helmet
laws or else lose millions in federal highway funds. It would have
reinstated a similar requirement that, after a lobbying campaign by
motorcyclist groups, was repealed in 1995.

In a preemptive strike, the rider groups alerted their members
and encouraged them to connect with their lawmakers on the issue. They
had defeated a similar helmet proposal two-to-one in 2005. Lautenberg
ditched his pro-helmet idea without even offering it up for formal
consideration. A Lautenberg spokesman said that the senator "remains
committed to strengthening helmet laws and is pursuing several
strategies to increase helmet use across the country."

Death toll climbing

As more riders have gotten on the road and the number of states with
mandatory helmet laws has declined, biker deaths have soared.

The death toll climbed from 2,116 in 1997 to 4,502 in 2010, the most
recent year for which figures are available. Motorcycle-related
fatalities accounted for 14 percent of the 32,885 deaths overall from
motor vehicle crashes in 2010, which officially is the lowest total since 1949.

The victims last year included 17- year-old Caroline Found of Iowa
City, Iowa, who died after she lost control of her moped and struck a
tree. They also included Philip Contos, 55, who was killed while
participating in a rally to protest New York's mandatory helmet law.
Police say Contos, who resided near Syracuse, N.Y., would have survived
had he been obeying the law.

The irony of Contos's death attracted widespread media attention,
although friends say he would have been repulsed by the idea that he had
become a poster boy for helmet laws.

Four teenage friends of Found, motivated by her death, launched a
campaign to persuade the Iowa legislature to enact a helmet law. (Along
with Illinois and New Hampshire, Iowa allows riders of all ages to go
helmet-less.) Their bid fell short. "It is getting to the point where
we're going to have to bubble wrap everyone just to protect them from
everything," a state legislator told the young activists, explaining his
opposition to a ban. "I think there's got to be some common sense
here."

Helmet advocates say it is the public that ends up getting ripped off
when it has to pick up the tab for health costs associated with
catastrophic accidents.

"If you don't wear a helmet, and you sustain a moderate to severe
injury that doesn't kill you, you are going to be a drain on society for
the rest of your life," said Thomas J. Esposito, chief of the Division
of Trauma, Surgical Critical Care and Burns at Loyola University Medical
Center in Chicago.

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NHTSA once tried to take a lead role in providing information to
states considering helmet laws. It set aside $330,000 in 1995 and 1996
for the cause, including a $149,000 contract for a video and white paper
for state legislators.

The video
– titled "Without Motorcycle Helmets, We All Pay the Price" – featured
testimonials from helmet-wearing crash survivors and a trauma-room
physician who compared helmets to "a vaccine" because of the compelling
evidence they reduced brain injuries.

Controversy revved up when the Motorcycle Riders Foundation obtained
an early copy of the pro-helmet video and began distributing it to
friends in Congress. Rider groups portrayed the situation as an example
of NHTSA using federal tax money to lobby against the interests of
taxpaying bikers.

They found a champion in Sensenbrenner, and in 1998 Congress enacted a
sweeping measure that barred NHTSA from attempting to influence state
and local legislators on any pending legislation. NHTSA representatives
could appear as witnesses, but only in response to an official
invitation.

With NHTSA more recently signaling stepped-up interest in promoting helmet use, Sensenbrenner has emerged as a lead opponent again, sponsoring a resolution, now in the hands of a House subcommittee, that would reaffirm the agency's lobbying ban.

Novelty helmets

NHTSA is facing opposition to motorcycle checkpoints, too. The agency
in 2010 earmarked $350,000 to help state police set up stops to check
motorcyclists for safety violations. One intent is to crack down on
so-called novelty helmets, which do not meet federal standards but
account for an estimated one in five of the helmets riders wear. The
helmets have become popular because they are lightweight and come in
various styles — and because they can keep police away in states that
mandate helmet use.

But they are also dangerous. "They are just plastic toys,
essentially," says Tim McMahon, a San Jose, Calif., personal-injury
lawyer, who won a $1.7 million injury award for a Fresno man who
suffered brain damage from a 2005 crash while wearing a novelty helmet
that he thought was safe.

Despite the risks, motorcyclists have gone to court to block
regulation. In a test case, four bikers who were ticketed in 2008 at a
checkpoint in New York for lacking approved helmets filed a lawsuit in
federal court, claiming that inspections singling out motorcyclists were
illegal discrimination. A judge dismissed the suit last year.

The American Motorcyclist Association, taking another tack, fired off
a letter in late 2010 urging NHTSA administrator Strickland to suspend
the federal checkpoint grant program, saying there were unanswered
questions about the program's implementation, legality and efficacy. Strickland declined.

Biker groups were further incensed when the agency subsequently made a
grant to the state of Georgia, which used the money in March, 2011 to
monitor bikers headed south to the legendary Daytona Beach Bike Week.

Motorcycle activists again found a sympathetic ear in Sensenbrenner,
who introduced legislation to end federal funding of motorcycle-only
roadside checkpoints. The anti-checkpoint measure may be considered by a
House-Senate conference committee currently working on a long-term
surface transportation bill.

"These checkpoints are not an effective use of taxpayer money,"
Sensenbrenner said, in a prepared statement in response to questions.
"Motorcycle-only checkpoints force law enforcement officials to play
'nanny state' to all riders rather than focusing on those who are
endangering themselves and others on the road, and do not address the
factors that contribute to motorcycle crashes."

"The federal government says all day long: 'You guys are a huge
problem. You are killing yourselves out there. You need to start wearing
helmets.' But then they do not want to put resources" toward training
and accident prevention, said Jeff Hennie, a Washington-based lobbyist
for the Motorcycle Riders Foundation.

But the advantages of training are questionable. A 2009 study
for the federal Transportation Research Board found that the evidence
was inconclusive about whether educating riders through formal programs
made them any safer.

Other studies have shown that, while training helps riders pass basic
skills tests, their chances of getting in a crash after six months of
driving are about the same as untrained riders. That raised questions
even for Tim Buche, president of the industry-sponsored Motorcycle
Safety Foundation, which has developed the training materials most
widely used in the U.S. "Maybe the training does not change someone's
true behavior for the long term," he speculated.

Even if training pays off, public health advocates argue that relying
on it exclusively would be equivalent to, in the automotive world,
exempting people who take a driver's education course from requirements
to use seat belts or to put children in car seats.

Doctors such as Esposito who provide care for the people hurt in
those crashes, though, sometimes are mystified about why riders don't
take it upon themselves to wear safe helmets for their own protection.

Asked whether he often thinks about how a patient with a head injury
could have avoided his plight simply by wearing a helmet, Esposito
replied: "All the time."

It is an interesting yet complex topic. I always wear a Snell-approved helmet and wouldn’t feel comfortable without one. I also founded one of the top riding schools on the east coast.

Modern helmets prevent most all traumatic brain injuries. Non-fatal traumatic brain injuries happen when the brain impacts the skull, then (generally) rotates against the rough inner surface, tearing brain matter and producing swelling. Fatal brain injuries have other types too.

Still, when Florida repealed their helmet law, half the riders immediately stopped wearing one. But traumatic brain injuries only only rose by about 10% (rather than the 50% one might expect.)

The reason appears to be that riders who didn’t want to wear helmets had always been wearing fake (novelty) helmets like the one in the picture above. These provide no protection from brain injury—zero. So the injuries were already happening before repeal.

So unless laws are enforced with zero tolerance for fake helmets, they have only marginal effect. People who want to protect their brain will wear helmets and people who don’t will wear non-protective fakes. I see these fake helmets every day.

It may well be that our public policy dollar is better spent on education.

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